General Life Expectancy Research Articles

Using Survival Analysis to Improve Estimates of Life Year Gains in Policy Evaluations

Policy evaluations taking a lifetime horizon have converted estimated changes in short-term mortality to expected life year gains using general population life expectancy. However, the life expectancy of the affected patients may differ from the general population. In trials, survival models are commonly used to extrapolate life year gains. The objective was to demonstrate the feasibility and materiality of using parametric survival models to extrapolate future survival in health care policy evaluations. We used our previous cost-effectiveness analysis of a pay-for-performance program as a motivating example. We first used the cohort of patients admitted prior to the program to compare 3 methods for estimating remaining life expectancy. We then used a difference-in-differences framework to estimate the life year gains associated with the program using general population life expectancy and survival models. Patient-level data from Hospital Episode Statistics was utilized for patients admitted to hospitals in England for pneumonia between 1 April 2007 and 31 March 2008 and between 1 April 2009 and 31 March 2010, and linked to death records for the period from 1 April 2007 to 31 March 2011. In our cohort of patients, using parametric survival models rather than general population life expectancy figures reduced the estimated mean life years remaining by 30% (9.19 v. 13.15 years, respectively). However, the estimated mean life year gains associated with the program are larger using survival models (0.380 years) compared to using general population life expectancy (0.154 years). Using general population life expectancy to estimate the impact of health care policies can overestimate life expectancy but underestimate the impact of policies on life year gains. Using a longer follow-up period improved the accuracy of estimated survival and program impact considerably.

Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients.

OBJECTIVE The purpose of this study was to compare long-term prognosis after meningioma surgery in elderly and younger patients as well as to compare survival of elderly patients with surgically treated meningioma to survival rates for the general population. METHODS Five hundred meningioma patients (median follow-up 90 months) who underwent surgery between 1994 and 2009 were subdivided into "elderly" (age ≥ 65 years, n = 162) and "younger" (age < 65 years, n = 338) groups for uni- and multivariate analyses. Mortality was compared with rates for the age- and sex-matched general population. RESULTS The median age at diagnosis was 71 in the elderly group and 51 years in the younger group. Sex, intracranial tumor location, grade of resection, radiotherapy, and histopathological subtypes were similar in the 2 groups. High-grade (WHO Grades II and III) and spinal tumors were more common in older patients than in younger patients (15% vs 8%, p = 0.017, and 12% vs 4%, p = 0.001, respectively). The progression-free interval (PFI) was similar in the 2 groups, whereas mortality at 3 months after surgery was higher and median overall survival (OS) was shorter in older patients (7%, 191 months) than in younger patients (1%, median not reached; HR 4.9, 95% CI 2.75-8.74; p < 0.001). Otherwise, the median OS in elderly patients did not differ from the anticipated general life expectancy (HR 1.03, 95% CI 0.70-1.50; p = 0.886). Within the older patient group, PFI was lower in patients with high-grade meningiomas (HR 24.74, 95% CI 4.23-144.66; p < 0.001) and after subtotal resection (HR 10.57, 95% CI 2.23-50.05; p = 0.003). Although extent of resection was independent of perioperative mortality, the median OS was longer after gross-total resection than after subtotal resection (HR 2.7, 95% CI 1.09-6.69; p = 0.032). CONCLUSIONS Elderly patients with surgically treated meningioma do not suffer from impaired survival compared with the age-matched general population, and their PFI is similar to that of younger meningioma patients. These data help mitigate fears concerning surgical treatment of elderly patients in an aging society.

Markers of Frailty in Cancer Treatment Election: A Case Report

Management of elderly oncology patients presents some difficulties when deciding if a patient is suitable for curative treatment or not. Apart from the tumour characteristics, there might be some other factors that influence in this decision, as previous illnesses, disability or general life expectancy. Standardized geriatric assessment must be applied in these cases, evaluating frailty in the elderly as one important prognosis factor, as it has been related to higher mortality and worst treatment tolerance. As symptoms, signs and exploratory findings can have common characteristics both for cancer and frailty, it is necessary to find other paths for approaching the frailty diagnosis that may influence the kind of treatment that a cancer patient receives. Biochemical markers are being developed, but in most cases they are not specific for cancer or frailty. Cardiovascular risk of patient, taking account on the analytic evolution of cardiovascular risks factors in the years previous to the neoplasia diagnosis, can help in the evaluation of the patient´s prognosis. DNA methylation pattern changes with age, and is also altered in cancer patients. This fact relates the apparition of cancer with aging. Further research must investigate on this subject, in order to identify possible methylation patterns that can discriminate frail cancer patients and non frail ones.

Years of life lost due to metastatic melanoma in 12 countries

Background:Regionally or distantly metastatic melanoma (stages IIIB/C and IV) place a high burden on society. To quantify this burden, this study estimated years of life lost (YLL) per patient for adults with metastatic melanoma in 12 countries in 2014.Methods:General population growth and life expectancy were estimated from the Organization for Economic Co-operation and Development data and life tables for each country. Incidence of melanoma and mortality rates for the disease were based on GLOBOCAN and US registry data. The prevalence of metastatic melanoma was calculated using mortality rates and survival data from patients with melanoma. YLL per patient was estimated by the difference between the disease-free life expectancy and the life expectancy with metastatic melanoma.Results:YLL per patient were as follows: Australia, men = 19.9 years, women = 22.7 years; Brazil, 16.3, 19.8; Canada, 19.4, 22.3; France, 18.8, 23.1; Germany, 18.3, 20.8; Italy, 19.3, 22.7; Mexico, 17.2, 19.0; the Netherlands, 18.5, 21.5; Spain, 19.2, 23.1; Sweden 19.4, 22.0; the UK, 18.7, 21.2; and the US, 17.9, 20.6.Conclusions:The burden of metastatic melanoma as measured by YLL is substantial in all 12 countries; although there is variation across countries and between men and women.

Treating Osteonecrosis of the Femoral Head: SOIB Method - Core Decompression and Introduction of Mesenchymal Cells: Case Report

Osteonecrosis of the femoral head is a pathologic process with multifactorial origins, characterised by pain, alteration of the anatomy and biomechanics of the hip and increasing patient disability. The treatment method depends on the stage of the disease, the size and location of the lesions, whether the involvement is uni- or bilateral, the age of the patient, how active the patient is, their general health conditions and life expectancy. The unsatisfactory results obtained in saving the femoral head using the available methods have lead in recent years to renewed interest in this disease and seeking new methods and treatments aimed at arresting its development or even preventing its onset. We present a clinical case study of a new method involving core decompression combined with the introduction of mesenchymal cells through a specific titanium screw called “SOIB”.

Comparison General Health and Life Expectancy between Students with Favorable and Unfavorable Socioeconomic Status

Introduction: The present study aims to compare general health and life expectancy between students with favorable and unfavorable socioeconomic status. Methods: The statistical population in this study consists of all the students of Lamerd city in the second semester of the academic year of 2013-2014. The sample of this study consists of 200 male and female students. A hundred of them are in the favorable socioeconomic status and the other 100 are in the unfavorable socioeconomic status which were selected by multistage random sampling. Results: The results of the analysis of MANOVA on the mean of life expectancyand general health scores indicated that there is a significant difference between the two groups regarding the investigated variables. Conclusion: In general, given the vulnerability of people who are in low socioeconomic status compared to the other segments of the society, more attention should be paid to this issue by the authorities.

Percutaneous posterior stabilisation of L1 to L5 with microsurgical decompression of L3/4, and percutaneous L3 biopsy, in a spinal metastasis

Although guidelines (Harrington [1], Tokuhashi [2], Tomita [3]) for the treatment of spinal metastasis exist, the indication for an operative therapy is still a complex decision. In general, therapeutic decisions should be made in a multidisciplinary setting, taking into account alternatives, the morbidity of the planned surgery as well as the general health condition and life expectancy of the patient. Beside all therapeutic alternatives there are widely accepted indications for operative treatment, which are spinal instability, radio resistant tumours, clinically relevant neural compression, deformity and intractable pain. Especially the percutaneous stabilisation techniques, which evolved over the last years became an important tool for the treatment of spinal metastasis in particular in the presence of spinal instability. Although fusion can seldom be achieved with percutaneous stabilisation, often this is of moderate importance because of the limited life expectancy of the patients. When a neural compression is accompanying the instability, stabilisation can easily be supplemented with a microsurgical decompression.

Life Expectancy In Zimbabwe: An Analysis Of Five Decades

Great inconsistencies have been observed in life expectancy dynamics in Zimbabwe over the past decades. Contradictions exist among Zimbabweans where some believe that people used to live longer during the colonial era than they live now. Such beliefs have been exacerbated by the recent economic woes that ensued in the country. Dynamics in the Zimbabwean life expectancy patterns have seen male Zimbabweans outliving their female counterparts since the year 2000. Such an alteration contradicts general world life expectancy trends where females commonly live longer than males. This paper analyses trends in the Zimbabwean life expectancy over the period 1970 to 2012. The ordinary least squares method is used to examine the impact of economic growth, inflation, increase in agriculture land, population growth and the dependency ratio on life expectancy in Zimbabwe. Empirical results from this study revealed that economic growth, inflation and population growth have a positive relationship with life expectancy while increases in both agricultural land and the dependency ratio have negative effects on life expectancy in Zimbabwe.

Epidemiology and outcomes of older patients admitted to Scottish intensive care units: a national database linkage study

BackgroundAs the general population ages and life expectancy increases, health-care use by elderly people increases, including intensive care. Rationing and variation of access are ethically and politically challenging. We aimed to characterise the population-based incidence of intensive care unit (ICU) admissions of elderly people in Scotland; compare ICU admission and mortality between elderly and younger populations; and compare treatment intensity between these groups. MethodsWe extracted complete, national 6-year cohort Scottish ICU admissions (Jan 1, 2005, to Dec 31, 2010) from the Scottish Intensive Care Society Audit Group database, which we linked to hospital Scottish Morbidity Record (SMR01) and death records. Annual incidence of ICU admissions of people aged 80 years or older was standardised for sex and socioeconomic status to the standard Scottish population (≥80 years) 2005–10. We compared mortality of elderly and younger people (<65 years) using the log-rank test. FindingsDuring 2005–10, 47 779 people were admitted to ICU (4561 patients ≥80 years [9·5%, 35·0/10 000 population], 26 784 patients <65 years [56·1%, 13·2/10 000]). Incidence of ICU admissions of elderly people fell from 36·6/10 000 population (95%CI 34·0–39·2) in 2005 to 30·3/10 000 (28·0–32·5) in 2010. ICU mortality was higher in elderly than in younger people (26·4% vs 16·1%, p<0·0001) as was 6-year mortality (68·0% vs 34·5%, p<0·0001). 2110 (80%) of 2627 elderly survivors were discharged home (younger 92%, 19 221/20 902), with a further 373 (14·2%) given rehabilitation (younger 1063, 5·1%) (χ2=525, p<0·0001). Age was an independent predictor of mortality (odds ratio 1·46, 95% CI 1·23–1·73, p<0·0001) after adjustment for confounders. In the pneumonia subgroup (elderly 294, younger 2167), mean acute physiology scores were similar (17·0 [SD 6·4] vs 17·6 [6·6]), organ support was higher in the elderly patients (77·0% vs 68·1%, p<0·0001), and median ICU length of stay was lower (6 days [IQR 3–13] vs 8 [3–16], p<0·0001). InterpretationThis study has shown that, by contrast with previously published research, admission rates of elderly people in Scotland fell between 2005 and 2010. Only the fittest elderly individuals were admitted to ICU, where initially they received a higher intensity of treatment than did younger patients; however, duration of ICU stay was shorter. Mortality rates were high, and age was an independent predictor of mortality. FundingFunding assistance for AD's MPH from Scottish Intensive Care Society, Scottish Society of Anaesthetists, Edinburgh Anaesthetics Research and Education Fund.

Üreter Darlıklarına Güncel Yaklaşım

Early diagnosis and treatment of ureteral obstructions are important in terms of protection of renal function. Ureteral strictures which have benign or malignant etiology, can take place a lot of intrinsic and extrinsic reasons. The primary objective is decompression of existing urinary obstruction. Treatment option should be based on according to general conditon and life expectancy of patient, etiology, length and localisation of stricture and renal function. In benign uretral stricture extensive use of endourologic, laparoscopic and robot-assisted treatment options, aplicability and treatment results were reported in various studies, the preference of minimally invasive methods have increased instead of open surgery. DOI:10.4274/kiud.15

The pursuit of longevity - the bringer of peace to the middle East.

Despite the common apprehensions regarding the aging population, this work aims to argue, on both deontological and utilitarian moral grounds, that any increase in general life-expectancy will be beneficial for the Middle East, countering the common fears associated with this increase. A set of ethical arguments concerning increasing longevity is presented, from both the deontological and utilitarian perspective. A wide selection of economic, psychological, demographic and epidemiological literature and databases is analyzed to determine common correlates of extended longevity. On the deontological grounds, the value of extended longevity is derived from the value of life preservation, regardless of its term. On the utilitarian grounds, the value of extended longevity is demonstrated by its correlation with further human values, such as education level and intellectual activity, economic prosperity, equality, solidarity and peacefulness. With the common apprehensions of stagnation and scarcity due to life extension found wanting, the pursuit of longevity by the population can be seen as a cross-cultural and cross-generational good. Though the current study mainly refers to sources and data relevant to the Middle East, a similar pro-longevity argument can be also made for other cultural contexts. In view of its numerous benefits, normatively, the goal of longevity should be set clearly and openly by the society, and actively pursued, or at least discussed, in academia, the political system and broader public.

Abstract P2-18-17: Breast cancer surgery for the elderly - Are we meeting a growing need?

Abstract Background≤br≥Between 2002 and 2011, in the UK, the number of people aged 90 increased by 26%. By 2034 the number of people aged 85 and over, is projected to be 2.5 times larger than in 2009. Life expectancy of 80 year old woman is now 9.4 years. These population statistics bring challenges to the provision of healthcare in general and Breast Cancer Services will see a significant increase in the number of very elderly patients. Prior to 2009 it was common place to treat patients aged over 80 with endocrine therapy alone, avoiding surgery, however as the general life expectancy for this age group has improved this is no longer recommended management. NICE guidelines issued in February 2009 recommend surgery for breast cancer where possible over endocrine treatment We aim to review the proportion of patients presenting with breast cancer aged over 80, assess their management and survival during a 12 year period and audit patients presenting after 2009 against NICE guideline to explore reasons for noncompliance. Methods We have conducted a retrospective audit of all patients presenting with breast cancer to a single high-volume center from 2000-2012. Patients were identified from a comprehensive departmental database recording patient demographics as well as treatment modality. For patients treated after 2009, case records were accessed to assess the reasons for omitting surgery. One-tailed Fisher's Exact Test used throughout to calculate p-values. Results≤br≥5446 patients were treated at our unit from 2000-2012 with the over 80's comprising 6.0-8.7% p.a. This age group increased over time by 29% from 6.5% in 2000-2003 to 8.4% (p = 0.0001) in 2009-2012. The population aged 90 or over increased by around 50% from 1.7% to 2.6% (p = 0.06) in the same period. The table below shows changes in the proportion of patients offered surgery before and after the 2009 guidelines. Patients Undergoing Breast Cancer SurgeryPatients aged 80-89Patients aged 90 and over2000- 20082009-2012p-value2000-20082009-2012p-value267/396 (67%)172/230 (75%)0.0318/64 (28%)21/47 (44%)0.05 Following introduction of regional anaesthesia without General Anasthesia in 2011, the proportion of patients aged over 90 having surgery, increased further to 16/25 (64% p-0.0031). In the 10 year period from 2001-2010 the mastectomy rate was 60% in the over 80's and 45% in the over 90 year old, however this difference was not statistically significant (p = 0.29). We have accurate survival data for 396 patients who died during follow up. No patients died within 12 months of surgery. The median survival was 40 months following surgery and 27 months for patients treated with primary endocrine therapy. 16/218 patients aged 80-89 and 2/111 patients aged over 90 at diagnosis required resectional surgery after relapse on primary endocrine therapy. Of patients not having surgery after 2009, 48 were deemed unfit and 36 declined surgery. Conclusions≤br≥The elderly is a growing part of our population of breast cancer patients. We have increased the proportion of elderly patient having surgery in line with NICE guidance, partly due regional anaesthesia for breast surgery and modification of care pathways. The relapse rate following primary endocrine therapy was very low in the most elderly patients. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-18-17.

A survey of patterns of practice on palliative radiation therapy for bone metastasis in Korea

The aim of this study was to understand the practice patterns of palliative radiation therapy for bone metastasis in Korea among Korean radiation oncologists by survey and to determine the decision factors affecting the prescription of radiation therapy fractionation schedules. An Internet-based survey was performed from October 5 to October 23, 2009, among 177 active full members of the Korean Society for Radiation and Oncology (KOSRO). The survey questionnaire included general information about the respondent, three types of clinical scenario, depending on the life expectancy of the patients, and the decision factors that affected the prescription of a radiation therapy schedule. The most prescribed schedule was 30Gy in 10 fractions regardless of the life expectancy of the patient. Also, it was found that a single fraction was seldom prescribed routinely in Korea. An increasing number prescribed fewer than 10 fractions as the life expectancy shortened; however, the prescription rate of a single fraction was still low. The general performance (and/or accompanying diseases) of patients and the life expectancy were the most considered factors in deciding the prescription of radiation therapy. Despite the abundant evidence supporting the equivalence of single- and multi-fraction radiation therapy, still, most Korean radiation oncologists continue to prescribe multi-fraction schedules depending on the general performance and life expectancy of the patients. Thus, we confirmed that there was a gap between evidence and practice, and treatment prescriptions can be strongly affected by decision factors other than published literature results.

Experience with the treatment of bisphosphonate-related osteonecrosis of the jaw

This article covers the authors' experience with the treatment of bisphosphonate-related osteonecrosis of the jaw in 11 individuals. A retrospective study of patients diagnosed and treated for bisphosphonate-related osteonecrosis of the jaw at the Department of Dentistry, University Hospital Hradec Králové during the period January 2006 to October 2012. The treatment protocol consisted of antimicrobial mouth rinses and systemic antibiotic administration according to the stage of the disease. Additional surgical debridement and sequestrectomy in combination with antimicrobial therapy was performed in two cases. Complete healing was achieved in six patients. In two cases, satisfactory healing was noted. Stage of the disease was lowered and only a small area of asymptomatic necrotic bone of up to five mm in diameter persisted. Two patients developed a stable disease without progression. In one patient, the disease progressed to the third stage with osteonecrosis involving all quadrants of both jaws. From these data it was concluded that conservative approach in the treatment of bisphosphonate-related osteonecrosis of the jaw led to symptom regression but was not curative. Surgical intervention, however, bears the risk of further progression of the osteonecrosis and must be carefully planned with respect to the patient's general health status and life expectancy. The treatment of bisphosphonate-related osteonecrosis of the jaw is generally difficult. For this reason, prevention plays a predominant role in the management of the disease.

Screening for Prostate Cancer: A Guidance Statement From the Clinical Guidelines Committee of the American College of Physicians

Prostate cancer is an important health problem in men. It rarely causes death in men younger than 50 years; most deaths associated with it occur in men older than 75 years. The benefits of screening with the prostate-specific antigen (PSA) test are outweighed by the harms for most men. Prostate cancer never becomes clinically significant in a patient's lifetime in a considerable proportion of men with prostate cancer detected with the PSA test. They will receive no benefit and are subject to substantial harms from the treatment of prostate cancer. The American College of Physicians (ACP) developed this guidance statement for clinicians by assessing current prostate cancer screening guidelines developed by other organizations. ACP believes that it is more valuable to provide clinicians with a rigorous review of available guidelines rather than develop a new guideline on the same topic when several guidelines are available on a topic or when existing guidelines conflict. The purpose of this guidance statement is to critically review available guidelines to help guide internists and other clinicians in making decisions about screening for prostate cancer. The target patient population for this guidance statement is all adult men. This guidance statement is derived from an appraisal of available guidelines on screening for prostate cancer. Authors searched the National Guideline Clearinghouse to identify prostate cancer screening guidelines in the United States and selected 4 developed by the American College of Preventive Medicine, American Cancer Society, American Urological Association, and U.S. Preventive Services Task Force. The AGREE II (Appraisal of Guidelines, Research and Evaluation in Europe) instrument was used to evaluate the guidelines. ACP recommends that clinicians inform men between the age of 50 and 69 years about the limited potential benefits and substantial harms of screening for prostate cancer. ACP recommends that clinicians base the decision to screen for prostate cancer using the prostate-specific antigen test on the risk for prostate cancer, a discussion of the benefits and harms of screening, the patient's general health and life expectancy, and patient preferences. ACP recommends that clinicians should not screen for prostate cancer using the prostate-specific antigen test in patients who do not express a clear preference for screening. GUIDANCE STATEMENT 2: ACP recommends that clinicians should not screen for prostate cancer using the prostate-specific antigen test in average-risk men under the age of 50 years, men over the age of 69 years, or men with a life expectancy of less than 10 to 15 years.

Behandlungsstrategien bei Wirbelsäulenmetastasen

Spinal metastases occur in 10 % of all carcinoma patients in the course of their oncologic disease. Spinal metastasis is a manifestation of a systemic oncologic disease. The treatment of the metastasis does not influence the overall oncological outcome. Treatment decision is depending from the primary tumor, presence of neurological symptoms, stability of the spine, extent of visceral and osseous dissemination, general state of the patient and his life expectancy. Therapy should focus on the patient's needs and be correlated with the expectations and prognosis of the patient. There exist a number of valid prognostic scores to support and objectify the decision. There has been a change of paradigmata with regard to surgical treatment, supported by an improvement in oncosurgical and anesthesiological fields. Surgery is indicated in case of instability or neurological compromise, in respect of the general state and life expectancy and can be performed from a ventral, dorsal or combined approach. Alternative or complimentary treatment methods are radiotherapy, chemotherapy, hormonotherapy, stereotactic radiosurgery and additive therapies like sequential embolization, antiresorptive medication or corticoid therapy. Therapy should be established by a multidisciplinary tumor board. Main issue for treatment decisions is palliation and optimizing the patient's quality of life.

Can We Really (All) Work Longer?&lt;br&gt;Trends in Healthy Life Expectancy According to Social Stratum in Germany&lt;br&gt;

Against the background of raising the retirement age to 67 years and the associated lengthening of working lifetimes in higher age groups, this article examines the question of the extent to which this political objective is covered by the health assets of the population. Here, we will first trace trends in “healthy” life expectancy among the total population for different points in time 1989, 1999 and 2009 on the basis of the data from the Socio-Economic Panel Study (SOEP) and analyse these against the background of social strata indicators such as income and educational levels. Among others, one significant result is the fact that social differences have a far greater effect on healthy life expectancy than on general life expectancy and that these differences increase further over the course of time. This effect can be found particularly in men. One mandatory uniform working lifetime for all persons would however not do justice to these findings of socially highly unequally distributed life opportunities. Instead, the findings support a flexible arrangement of retirement age limits.

A case of membranoproliferative glomerulonephritis associated with metastatic colon cancer

A case of membranoproliferative glomerulonephritis associated with metastatic colon cancer

Breast cancer in women over 70 years of age: guidelines for diagnosis and treatment

In Brazil, life expectancy among women is 75 years. The current population aged over 70 years exceeds 4.5 million, and is expected to grow even more in the coming years. Contrary to expectations, the clinical outcome of breast cancer appears to be similar in both younger and older women. Level I evidence randomized prospective studies involving patients older than 70 years with breast cancer are scarce. Early diagnosis using mammography enables less aggressive treatments. Therefore, the need for mammographies should not be overlooked in elderly women. Surgical treatment carries low morbidity and mortality even among elderly women. Nonetheless, comorbidities, impaired general health status and limited life expectancy are factors that limit systemic treatment and radiotherapy in these women. Thus, the elderly are more prone to undertreatment leading to reduced overall survival and disease-free survival. Whenever possible, the approach to breast cancer in women over age 70 should comply with protocols previously established for younger women. Comorbidities, performance status and life expectancy should be factored in planning for individualized treatment.

Urban-rural differences in dental caries experience among 6-year-old children in the Russian north

Russians residing in rural areas, particularly in the north, have poorer health in general and lower life expectancy compared with urban residents. Little is known about dental health in the north of Russia, given that the last national oral health survey was performed more than 10 years ago. The aim of this study was to estimate the prevalence and experience of dental caries among 6-year-old children in a remote region in Northwest Russia. In total, 532 children aged 6 years were recruited in 5 randomly selected rural and urban settings of the Arkhangelsk region. Girls comprised 50.8% of the sample. Caries experience was assessed at D3 (cavitation) level by a single calibrated examiner. The prevalence of caries was calculated as the number of children with at least one affected tooth (decayed or missing or filled) divided by the number of examined children x 100% with 95% confidence intervals (CI). Caries experience was estimated using a sum of decayed, missing, filled teeth (dmft index) and presented as means and 95% CIs. Dichotomous and continuous data were analysed using Χ² and Mann-Whitney tests, respectively. The prevalence of caries was 93.4% (95% CI: 90.9-95.2) with a mean dmft of 6.71 (95%CI: 6.37-7.04). On average, there were 5.48 (95% CI: 5.16-5.80) decayed, 0.44 (95% CI: 0.37-0.51) missing and 0.79 (95% CI: 0.67-0.91) filled teeth. Although the overall caries experience was similar in rural and in urban areas (6.52 vs 6.41, p=0.742), the number of decayed teeth in rural areas was greater (5.94 vs 4.91, p=0.001). Moreover, there were fewer missing teeth (0.31 vs 0.59, p<0.001) and filled teeth (0.45 vs 1.19, p<0.001) in rural areas. Boys had a greater number of affected teeth than girls (7.12 vs 6.32, p=0.023). The levels of both caries prevalence and caries experience in the region exceeded the Russian average and corresponding levels in most European countries. Both urban-rural and sex variations in caries experience and its components were observed. Urgent preventive dental public health measures on both population and individual levels are needed to improve the situation.